Ovarian lesion volumes as a screening tool for malignancy in adolescent ovarian tumors

BackgroundPreoperative evaluation of ovarian tumors for malignancy is essential to determine appropriate treatment. Our study assessed the utility of ovarian lesion volumes to screen for malignancy in adolescent ovarian lesions.MethodsA retrospective chart review of adolescent patients (8–18 years) who underwent an ovarian operation from January 2008 to December 2012. Data included demographics, ultrasonographic volume measurements, and tumor markers. Volumes were calculated using the prolate ellipsoid formula. Data are presented as medians.ResultsOne hundred twenty-three females were included at a median age of 13.7 years (IQR 12.5–16). Eight patients had malignancies. The median benign lesion volume was significantly smaller than malignant [152 cm3 (IQR 57–592)vs. 1548 cm3 (IQR 627–2105), p = 0.001].A receiver operating characteristic (ROC) curve analysis (AUC 0.84, p = 0.001) revealed a threshold ovarian lesion volume of < 184 cm3 (100% sensitivity, 54% specificity, NPV 100%, PPV 13%) to accurately screen for malignancy. This held true when applied to our dataset as none of the 62 girls with volumes < 184 cm3 had malignant pathology.ConclusionsThis is the first documented use of ovarian lesion volumes as a screening tool in adolescent ovarian lesions. This should be used in conjunction with tumor markers and other imaging features to better screen for malignancy.